Rituximab in autoimmune diseases

Virgolini, Luigi; Marzocchi, Vanda

doi:10.1016/j.biopha.2004.04.006

Cited by 39 publications

(13 citation statements)

References 122 publications

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“…The MFI is a 20-item self-report scale, which has been validated for SS (20) and is designed to objectively measure fatigue, including the following dimensions: 1) general fatigue, 2) physical fatigue, 3) mental fatigue, 4) reduced motivation, and 5) reduced activity. A higher score (possible range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] indicates a higher level of fatigue. The SF-36 questionnaire, which has been used for measuring subjective well-being, has also been validated for SS (21).…”

Section: Methodsmentioning

confidence: 99%

“…Rituximab, a chimeric murine/human anti-CD20 monoclonal antibody that binds to the B cell surface antigen CD20, is currently used in the treatment of B cell lymphomas (4)(5)(6). It is also considered a promising agent for treatment of various autoimmune disorders, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) (7)(8)(9). It has been hypothesized that because B cells appear to be involved in the pathogenesis of SS, B cell depletion may lead to a decrease of disease activity.…”

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confidence: 99%

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Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

447

300

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Objective. To investigate the safety and efficacy of B cell depletion treatment of patients with active primary Sjögren's syndrome of short duration (early primary SS) and patients with primary SS and mucosaassociated lymphoid tissue (MALT)-type lymphoma (MALT/primary SS).Methods. Fifteen patients with primary SS were included in this phase II trial. Inclusion criteria for the early primary SS group were B cell hyperactivity (IgG >15 gm/liter), presence of autoantibodies (IgM rheumatoid factor, anti-SSA/SSB), and short disease duration (<4 years). Inclusion criteria for the MALT/ primary SS group were primary SS and an associated MALT-type lymphoma (Ann Arbor stage IE) localized in the parotid gland. Patients were treated with 4 infusions of rituximab (375 mg/m 2 ) given weekly after pretreatment with prednisone (25 mg) and clemastine. Patients were evaluated, using immunologic, salivary/ lacrimal function, and subjective parameters, at baseline and at 5 and 12 weeks after the first infusion.Results. Significant improvement of subjective symptoms and an increase in salivary gland function was observed in patients with residual salivary gland function. Immunologic analysis showed a rapid decrease of peripheral B cells and stable levels of IgG. Human antichimeric antibodies (HACAs) developed in 4 of 15 patients (27%), all with early primary SS. Three of these patients developed a serum sickness-like disorder. Of the 7 patients with MALT/primary SS, complete remission was achieved in 3, and disease was stable in 3 and progressive in 1.Conclusion. Findings of this phase II study suggest that rituximab is effective in the treatment of primary SS. The high incidence of HACAs and associated side effects observed in this study needs further evaluation.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

447

300

View full text Add to dashboard Cite

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“…Disorders in which a B-cell clone producing autoantibodies is responsible for an autoimmune disease, are theoretically susceptible to be treated with this anti-CD20 antibody, with the intention of remove or annul the cellular source of such autoantibodies [16][17][18]. This selective targeted-induced B-cell depletion has been applied with promising results in cases of adult refractory or relapsed idiopathic thrombocytopenic purpura (ITP) [19,20], the most common haematological autoimmune disease, with a successful response which approximately varies from 30 to 50% [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Successful response to rituximab in two cases of acquired haemophilia refractory to standard-therapy

et al. 2008

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Acquired autoantibodies against coagulation factors (acquired haemophilia) frequently constitute a life-threatening bleeding situation requiring a prompt therapeutic intervention, including control of bleeding and secondarily an attempt of eradication of the inhibitor by prolonged immunosuppressive therapy. The combination of oral corticosteroids and cyplophosphamide seems to be effective to eradicate the autoantibody, but some patients may be resistant. Another therapeutic approach, recently described, observes treatment with the chimeric anti-CD20 monoclonal antibody rituximab. We report two consecutively treated patients whose acquired FVIII inhibitors did not respond to standard immunosuppressive regimens, and only when rituximab was added to therapy, complete response and prolonged remission were obtained.

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“…[2][3][4] Recovery of B cells begins 6-9 months after rituximab treatment, with levels returning to normal one year later. 5 Kazkaz and colleagues, Sundharam, and Cooper and colleagues reported no autoantibody titers reduction during the treatment with rituximab, 2,3,6 while Neidermeier and colleagues, Goebler and colleagues, and Herrmann and colleagues did report a decrease in antibody titers to desmoglein 3 and/or desmoglein 1.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and side effects of anti-CD20 therapy for autoantibody-mediated blistering skin diseases: A comprehensive survey of 71 consecutive patients from the Initial use to 2007

Peterson

Chan

2008

TCRM

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Abstract:In order to examine the effi cacy and side effects of the monoclonal antibody anti-CD20 (rituximab) on autoimmune blistering skin diseases, we performed a comprehensive survey of 71 consecutive patients from initial use up to 2007, using the PubMed database. A heterogeneous group of patients, including 51 patients with pemphigus vulgaris, one with pemphigus vegetans, nine with pemphigus foliaceus, fi ve with paraneoplastic pemphigus, four with epidermolysis bullosa acquisita, and one with both bullous pemphigoid and graft vs host disease was included in this survey. Overall the monoclonal antibody seems to be effective in that 69% of patients showed complete response, 25% of patients showed partial response, whereas 6% of patients showed progressive disease. Six deaths occurred in association with the treatment, with four of these deaths in patients with paraneoplastic pemphigus, a disease characteristically resistant to conventional medication and with a high mortality rate. Of note, 11 patients who received combined rituximab and intravenous immune globulin treatments had the best outcome: complete response without any serious side effects. Therefore further investigation on rituximab with controlled clinical trial is a worthy pursuit.

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Rituximab in autoimmune diseases

Cited by 39 publications

References 122 publications

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Successful response to rituximab in two cases of acquired haemophilia refractory to standard-therapy

Effectiveness and side effects of anti-CD20 therapy for autoantibody-mediated blistering skin diseases: A comprehensive survey of 71 consecutive patients from the Initial use to 2007

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